Colestid (Colestipol) – Oral

What Is Colestid?

Colestid contains the active drug colestipol, which belongs to the class of medications called bile acid sequestrants. It is used along with dietary changes to reduce the amount of fatty substances such as low-density lipoprotein (LDL) cholesterol, considered "bad" cholesterol, in people with high cholesterol.

Colestipol works by binding bile acids in the intestines to prevent their absorption from the small intestine. This causes the liver to convert cholesterol into bile acid, lowering cholesterol levels in the body.

Colestid is a prescription medicine available as tablets and granules to take by mouth.

What Is Colestid Used For?

Colestid is used along with a proper diet to reduce LDL cholesterol levels in the blood. This reduction in bad cholesterol helps decrease the risk of strokes and heart attacks.

Lifestyle changes, such as a healthy diet, exercise, and weight management, should be the first strategy used to lower cholesterol levels. However, if diet and exercise alone do not help, adding Colestid may be beneficial. In addition to taking medication, you must continue your lifestyle changes to get the maximum benefits.

Cholesterol checks are usually part of a routine medical checkup. If your healthcare provider finds that your LDL cholesterol is too high, they might prescribe Colestid to help bring it down.

How to Take Colestid

Read the prescription label carefully before taking your medication. Talk to your pharmacist or healthcare provider if you have questions about how to take it.

Colestid comes as oral tablets and granules. The tablets are usually prescribed to take once or twice daily, whereas granules are prescribed one to six times daily. Take these exactly as directed. Don't change the dose or take it more often than prescribed.

Unless otherwise instructed, take all other prescription or nonprescription drugs and herbal products at least one hour before or four hours after taking Colestid since Colestid can interfere with the absorption of many other drugs.

When taking Colestid:

• Swallow the tablets whole with a glass of water or other drinks (fruit juice, water, milk, or soft drink). Do not chew, split, or crush them.
• If you take granules, add them to at least 3 ounces of a liquid and stir until thoroughly mixed. After taking the dose, rinse the glass with a small amount of extra water and drink it to ensure that you take the entire dose.

Colestid granules may also be mixed with hot or regular breakfast cereals, thin soups, or pulpy fruit extracts.

Your healthcare provider may increase the dose gradually depending on your response to it. Continue to take your medication even if you feel well; do not stop it without consulting your healthcare provider.

Storage

Store away from heat, light, and moisture at room temperature (between 68 and 77 degrees F). Do not store it in the bathroom. Keep all medications locked away and out of reach of children and pets.

Do not keep unwanted and expired medicines with you. Don't throw the unwanted drugs in the waste bin, pour them down a drain, or flush them down the toilet. The best way to discard expired or no-longer-needed drugs is through a drug take-back program. Contact your pharmacist for information on where you can discard your medications safely.

Off-Label Uses

Healthcare providers may prescribe colestipol for off-label uses, meaning for conditions not specifically indicated by the Food and Drug Administration (FDA).

Colestipol is sometimes used off-label to treat pruritus (itchy skin) due to cholestasis, a condition in which the liver's bile flow is reduced or stopped. Bile acid sequestrants are recommended as the initial therapy to treat this condition.

However, the off-label use is based on limited and older data for cholestyramine (another cholesterol medication) and clinical experience. Although specific data for colestipol is lacking, it may be considered instead of cholestyramine based on patient preference.

What Are the Side Effects of Colestid?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or pharmacist. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Colestipol may cause side effects. The most commonly reported is constipation, which can be severe. However, most of the time it is mild and temporary.

You can reduce the severity of constipation by drinking more fluids and adding fiber to your diet. A stool softener may also be helpful. Tell your healthcare provider if your constipation becomes severe or does not go away.

Other reported side effects include:

• Abdominal pain
• Migraine or headache
• Hemorrhoids
• Musculoskeletal pain
• Fatigue
• Nausea
• Vomiting
• Gas

Severe Side Effects

Call your healthcare provider immediately if any of the rare but severe side effects occur, such as:

• Difficulty swallowing
• Chest pain
• Severe stomach or abdominal pain
• Unusual bleeding or bruising
• Rapid breathing
• Confusion

A very severe allergic reaction to Colestid is rare. Seek immediate medical help if you notice symptoms of a severe allergic reaction, including:

• Rash or itching
• Swelling of the face, tongue, or throat
• Severe dizziness
• Trouble breathing

Chronic use of colestipol may cause increased bleeding due to hypoprothrombinemia (a deficiency of the blood-clotting substance prothrombin) caused by vitamin K deficiency. It is advisable to monitor fat-soluble vitamin levels while on prolonged treatment with Colestid. 

Dosage: How Much Colestid Should I Take?

Modifications

Your healthcare provider may increase the dose of Colestid gradually depending on your body's response to treatment.

Additionally, if you normally have trouble swallowing pills, you might find that Colestid pills are too large for you. Discuss this with your healthcare provider before starting the tablets. The granules for suspension form could be a better option for you.

Since Colestid is known to interfere with the absorption of fat-soluble vitamins, you may need to use caution if taking it while pregnant or breastfeeding. Talk to your healthcare provider if you are pregnant or nursing while on Colestid.

Missed Dose

Take the missed dose as soon as you remember. If it is nearly the time of your next dose, skip the missed one. Continue your regular dosing schedule for the next doses. Don't take a double dose to make up for the missed dose.

Overdose: What Happens If I Take Too Much Colestid?

An overdose is not likely. However, if you do take too much, side effects would likely include an obstructed gastrointestinal tract. Call your healthcare provider promptly if you notice the following symptoms have become severe after taking more Colestid than prescribed:

• Stomach pain
• Bloating
• Nausea and vomiting
• Constipation
• Diarrhea

Precautions

What Are Reasons I Shouldn’t Take Colestid?

People who are hypersensitive to colestipol or any other components of Colestid should not take it.

What Other Medications Interact With Colestid?

It's possible for drug-drug interactions to occur when taking Colestid with certain other medications.

When used together, Colestid may delay or reduce the absorption of other oral medications. The time interval between the administration of colestipol and any other medicines should be as long as possible.

For example, taking Colestid before a single dose of a medication called propranolol (brand names include Inderal and Hemangeol) may decrease propranolol's absorption. If you are already taking propranolol, your healthcare provider may monitor your treatment more closely after adding or removing it.

To avoid impeding the absorption of these medications, it is recommended to take other drugs at least one hour before or four to six hours after Colestid. However, always check with your healthcare provider first to determine how you should time your doses.

Other drugs or substances that should not be taken at the same time as Colestid include:

• Diuril (chlorothiazide) 
• Tetracyclines
• Lasix (furosemide)
• Penicillin G
• Microzide (hydrochlorothiazide)
• Lopid (gemfibrozil)
• Oral phosphate supplements
• Hydrocortisone

Special care is required when taking digitalis preparations, as there are differing results for the effect of colestipol on the bioavailability (the extent and rate that a drug becomes completely available in your system) and absorption of Lanoxin (digoxin) and digitoxin. 

Colestipol may also decrease mycophenolic acid exposure and potentially reduce the efficacy of mycophenolate mofetil.

What Medications Are Similar?

Currently, three bile acid sequestrant drugs are available in the United States, including:

• Colestid (colestipol) is available as a tablet or resin powder.
• Welchol (colesevelam) is available as a tablet, chewable bar, and powder.
• Prevalite (cholestyramine) is available as a chewable bar and powder.

All of these drugs are used alone or combined with other medicines and dietary changes to reduce cholesterol levels in the blood.

How Can I Stay Healthy While Taking Colestid?

Colestid lowers bad cholesterol, known as LDL cholesterol, in the blood, which can help prevent heart attacks, stroke, and circulatory problems.

To get the most from this treatment, make healthy lifestyle changes in your diet and physical activity routine. Try to reduce the amount of salt in your diet and incorporate more fruits and vegetables and soluble fiber.

Keep your regular medical appointments. You may need to have blood tests to monitor your progress from time to time.